SAMPLE History Taking
Medical Patient Assessment for Altered Mental Status (AEIOUTIPS)|
Medical Patient Assessment for Chest Pain (OPQRST)
Medical Patient Assessment for Respiratory Distress (PASTE)
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The SAMPLE History Medical history obtained from the patient, family and bystanders
Signs and Symptoms Signs: what you can observe and measure about the patient, such as the vital signs. Symptoms: what the patient describes to you- pain, numbness...etc. You cannot observe these, so you must ask
Allergies: "Do you have any allergies?" This includes medication, food, or other environmental factors. Check for medical alert tags.
Medications: "Are you on any medications? Have you taken medications recently?" This includes prescriptions, over-the-counter, birth control pills, illicit drugs (be tactful, indicate that you are not an EMT, not a police officer, and you need the information for treatment purposes), or herbal medicine. Look for medical tags.
Pertinent past history: "Have you ever had any illnesses? Operations? Have you ever been admitted to a hospital?" Find out medical problems and past surgical procedures.
Last oral intake: "When did you last eat or drink something? What was it?" A diabetic patient who hasn't consumed anything for 8 hours may be hypoglycemic.
Events leading up to the injury or illness: "What happened? How did this happen?" The events leading up to the injury provide clues for the underlying cause.
Document all pertinent findings from the SAMPLE history on the PCR (Prehospital care report)